72,000 Deaths

Can the news from the Centers for Disease Control about 2017 drug overdoses BE any bleaker? The years 2016-2017 saw a record number of people dying from overdoses, which was more deaths than from guns, car crashes, or H.I.V.

Someone has done an analysis. Drugs are deadlier now (often due to mixing them with other substances besides the main drug), and more people are using. The good news is that where the deadlier drugs arrived earliest, such as in New England, some states are seeing the number of overdoses drop. Could that be from diligent public health campaigns and offering more addiction treatment, which they were hitting the problem with?

However, the writer reminds readers that you can’t totally trust the numbers. With an epidemic like the Zika virus, an infectious disease, people sought help, and public health officials moved, quickly. But with addiction, there’s that pesky STIGMA (detailed in an earlier post on this site this month), so that drug users may not have been truthful about their drug use when polled. Also, some drug users don’t have telephones or are hard to reach, and some deaths take longer to be researched and reported than others.

Deaths from Drug Addiction

As mentioned earlier, another reason for the astronomical number of deaths is that the drug supply is changing, as noted by an associate professor at the Brown University of Public Health. Fentanyl is being added to heroin, methamphetamine and cocaine, and even anti-anxiety medicines known as benzos, or benzodiazepines. (Stay tuned for a post on older people mixing benzos with opioids.) That’s especially bad news for “older, urban black Americans; those who used heroin before the recent changes to the drug supply might be unprepared for the strength of the new mixtures,” according to the article.

The East seems to be in a better position than the Midwest relative to this one part of the epidemic, because heroin that makes it way to the West is usually “processed into a form known as black tar that is difficult to mix with synthetic drugs.” The East, however, usually has a white powder that combines well with fentanyl.

Let’s hope that Dayton, Ohio, which has been in the news as a “hot spot” for opioid use, is the way of the future for other states. The county has a new emergency response strategy, is utilizing federal and state grants to combat drug use, and has reduced opioid prescribing and provided addiction treatment to prisoners in jails.

Drug Addiction Treatment Centers

There are other hopeful signs: Congress may step in with bills that mandate reductions in prescribing opioids, among other things, and along the same lines, experts are reminding people that we need more funding of public health programs.

There’s yet another action that might help which requires no funding and little effort. A behavioral economist at the University of California and the Chief Medical Examiner-Coroner for Los Angeles County wrote an opinion column to suggest that medical examiners and coroners tell doctors when their patients die of overdoses. They wrote that they believe that more careful prescribing would result if doctors were told, and they even set up a trial in San Diego County in 2015 to test their thesis.

They had a letter sent to half the doctors in the study who had prescribed opioids about that doctor’s patient’s death after each one happened. The letter wasn’t threatening “and gave the clinician a path toward safer prescribing.” The results of the study indicated doctors did reduce their prescribing and started fewer patients on opioids.

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